Is a vegan diet a healthy choice for type 2 diabetes?


If you’ve set foot in a supermarket, restaurant or coffee shop - or for that matter, shopped for food online - at any point over the last few years, you will have noticed the explosion of vegan product ranges. You might even have friends and family members dabbling in veganism, or who’ve adopted a fully plant-based diet.

2020 was a big year for veganism - half a million Britons went vegan and by 2025, over a quarter of the population will be vegan or vegetarian. [1] But could this dietary switch help with type 2 diabetes? Here we’ll dig into the benefits of a vegan diet and how to make it work for you. 


What constitutes a vegan diet?


A vegan diet excludes foods that come from animals... so meat, fish, eggs, poultry, milk, cheese, and other dairy products are off the menu. Some strict vegans even cross honey off the list. This means eating only plants (like vegetables, grains, nuts and fruits) and foods made from plants. While this type of diet is nothing new - the term ‘vegan’ was officially coined in 1944 and was first mentioned by Greek mathematician Pythagoras in 500 BC. - it’s become a mainstream global movement in our lifetime. [2]

People are motivated to follow a vegan diet for a number of different reasons, with one key incentive being to prevent the exploitation of animals. Many vegans strongly believe that all animals, including those that have long been staples in diets all over the world, have a right to life and freedom. But a vegan diet done right can offer tons of health benefits that are hard to ignore, from boosting mood and focus to offering protection against several types of cancers. [3][4][5] 


Okay - my interest is piqued. So how does it impact type 2 diabetes?


A plant-based diet is rich in good-for-you dietary fibre, antioxidants, and micronutrients, and is low in saturated fat - so in its very DNA, a balanced vegan diet can be great for overall health, even before you consider how it might help with type 2 diabetes. Here are a few ways a vegan diet can have a positive impact on type 2 diabetes. 


A vegan diet can encourage weight loss

Vegan diets tend to be lower in calories than those featuring animal-sourced foods, which could make losing weight and maintaining that weight loss a lot easier. In one study, a vegan diet helped participants lose 9.3 lbs (4.2 kg) more than a control diet over an 18-week study period. [6] And another showed that people on a vegan diet lost more weight than those who followed calorie-restricted diets, even when the vegan groups were allowed to eat until they felt full. [7] So even when people didn’t follow the vegan diet to the T, they experienced some weight loss - and not fixating on calories all the time means feeling freer to enjoy this new lifestyle! Evidence also supports the positive impact of weight loss on blood sugar control, and in some cases, complete remission of type 2 diabetes

Eating vegan foods can reduce blood sugar levels

Managing type 2 diabetes is all about keeping blood sugar levels in normal ranges to reduce the risk of complications resulting from the disease. It can be helpful to monitor your blood sugar levels yourself. Having a healthy weight can improve blood sugar control, but the components of a vegan diet - think vegetables, fruits, wholegrains, and nuts - will help with this too. 


Limiting your intake of animal products and refined foods like pastries, bread, and cakes as part of a vegan diet can lower both blood pressure and blood sugar levels pretty quickly once you’ve made the change, especially if you take diabetes medication. [8] One study found that a vegan diet controlled blood sugar three times more effectively than a ‘traditional’ diabetes diet, which restricts calories and carbohydrates. [9] 


Lowering blood sugar levels can make your body more responsive to insulin, which in turn may reduce the need for medication. Nearly half of participants in one study found they were able to reduce the amount of blood sugar lowering medication because they were on a vegan diet. [10] A happy accident? We think not.

A vegan diet can reduce the risk of cardiovascular disease

When you digest red meat, poultry, fish or eggs - all of which contain a nutrient called choline - the bacteria in your gut feeds off the choline and produces a substance called trimethylamine (TMA). Your liver then takes the TMA and converts it into TMAO - or the catchily named ‘Trimethylamine N-oxide’ to you and me. TMAO can increase plaque in the arteries and cause heart problems. But cutting out those TMA-producing foods with a vegan diet equals no TMAO - and the decrease happens fast. For example, in one study, after just one week of a plant-based lifestyle, people’s TMAO levels halved. [11]  


A vegan diet can increase the number and variety of plants you eat

Most people who switch to a vegan diet end up eating a greater number and wider variety of plants, which is only a good thing. There are a few reasons for this. To begin with, more plants equate to more fibre, which has been shown to reduce the risk of type 2 diabetes (among many other diseases). [12] In addition, eating more plants means you’ll be consuming more antioxidants. Lastly, eating a wider variety of plants has been shown to be beneficial for the microbiome, which we now know is linked to everything from blood sugar to mental health.


Is all vegan food healthy?


In short - sadly not. French fries and Oreos are vegan, after all. While some vegan foods are full of fibre, antioxidants, and health-boosting nutrients like potassium, magnesium, folate and vitamins A, C and E, it’s the processed items that can be the red herring. Foods that aim to mimic the texture of meats and animal products often contain added oils, stabilisers, and even sugars, and vegan junk food is ostensibly just as salty as its meaty counterparts. 


So... veganism is not necessarily the ‘healthful’ cure-all you might assume. If you’re thinking about going vegan, the best plan of action is to base your meals around whole, nutritious foods that happen to be vegan and save the processed vegan substitutes for more occasional treats. Vegan whole foods like beans, lentils, oats, nuts, vegetables, and fruits are all safe and healthy. While some whole foods like fruit can be high in sugar and therefore high in carbohydrates, the presence of fiber means that the absorption of these sugars is slowed way down when compared to fast-release sources of sugars such as sweets and pastries. . Hurrah for fibre! Provided you’re keeping an eye on the added sugars, you’re on the right track. 


The dangers of a vegan diet


As we’ve learned, going vegan can lead to incredible health results. But, as ever, there’s no silver bullet to health. Here are a few things to look out for if you’re going full vegan:

  • Lots of vegan foods contain high levels of added sugars and preservatives, and are highly processed. So just because something is labelled as “vegan”, don’t assume it’s good for you. In fact, your best bet is choosing foods that are naturally vegan and therefore don’t have to be labelled at all.
  • An unbalanced vegan diet can lead to nutritional deficiencies, such as low levels of vitamin B12, calcium, and iron. To avoid this, you’ll need to make sure you’re eating a wide variety of green, leafy plants, as well as nuts and legumes. 
  • While it’s becoming easier, maintaining a vegan diet when you’re eating out or traveling can be tough. You may find that you’re often having to opt for the less healthy option on a menu just because it’s vegan—so consider giving yourself some leniency when it means your overall choice is healthier.
  • Getting enough nutrients with a vegan diet is quite hard for children and adolescents, so be careful if you’re considering putting your kids on the diet too! [13]



And the big clincher?


So you’ve heard the evidence - a vegan diet can help you lose weight and reduce sugar levels, your dosage of medication and the risk of heart problems - but its biggest selling point? Research has shown that a plant-based diet can reverse type 2 diabetes in some cases. [9] As with all of our recommendations, we’ll never tell you that one diet will be the answer for everyone—but if veganism fits in with your lifestyle, go ahead and give it a shot. At the very least, we hope this article has convinced you of the many benefits of eating more plants, and encouraged you to add some more into your diet, vegan or not.


References


[1] UK Diet Trends 2021 - Finder. Retrieved May 5, 2021, from Finder

[2] A Brief History of Veganism - TIME. Retrieved May 5, 2021, from TIME

[3] Beezhold B., Radnitz C., Rinne A., DiMatteo J., Vegans report less stress and anxiety than omnivores. Nutr Neurosci. 2015 Oct; 18(7), 289-96. Accessible here

[4] Katcher HI., Ferdowsian HR., Hoover VJ., Cohen JL., Barnard ND. A worksite vegan nutrition program is well-accepted and improves health-related quality of life and work productivity. Ann Nutr Metab. 2010; 56(4), 245-52. Accessible here

[5] Dinu M., Abbate R, Gensini GF., Casini A., Sofi F., Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2017 Nov 22, 57(17), 3640-3649. Accessible here

[6] Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard ND. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr. 2013 Jul, 67(7), 718-24. Accessible here

[7] Barnard, N.D., Cohen, J., Jenkins, D.J.A., Turner-McGrievy, G., Gloede, L., Jaster, B., Seidl, K., Green, A.A. and Talpers, S. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes. Diabetes Care. (2006) 29(8), 1777–1783. Accessible here

[8] McMacken, M. and Shah, S. A plant-based diet for the prevention and treatment of type 2 diabetes. Journal of geriatric cardiology. 2016; 14(5), 342–354. Accessible here‌

[9] Tackle diabetes with a plant-based diet - Physicians Committee for Responsible Medicine. Retrieved May 5, 2021, from PCRM

[10] Barnard ND., Cohen J., Jenkins DJ., Turner-McGrievy G., Gloede L., Green A., Ferdowsian H,. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr. 2009 May, 89(5), 1588-1596. Accessible here

[11] Vegan diet could control blood sugar for people with type 2 diabetes - University of Leicester. Retrieved May 5, 2021, from University of Leicester News


[12] Veronese N, Solmi M, Caruso MG, Giannelli G, Osella AR, Evangelou E, Maggi S, Fontana L, Stubbs B, Tzoulaki I. Dietary fiber and health outcomes: an umbrella review of systematic reviews and meta-analyses. Am J Clin Nutr. 2018 Mar 107(3), 436-444. Accessible here.


[13] Sanders TA. Growth and development of British vegan children. Am J Clin Nutr. 1988 Sep, 48(3 Suppl), 822-5. Accessible here





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